D0497 - Metabolic Syndrome and Beta Blocker Use Is Associated With Portal Vein Thrombosis in NASH Cirrhosis

Asahi Hoque, MD, MPH, Cristina Batarseh, MD, Amir A. Qamar, MD
Lahey Hospital & Medical Center, Burlington, MA

Introduction: Portal vein thrombosis (PVT) is associated with increased morbidity of patients with cirrhosis due to worsening portal hypertension, increases surgical complications, and may have an increased risk of early graft failure. PVT is associated with non-alcoholic steatohepatitis (NASH). The primary aim of this study was to understand the prevalence of PVT in NASH cirrhosis and understand the risk factors associated with its presence.

Methods: A retrospective cohort review of patients who underwent liver transplant evaluation at a single tertiary liver transplantation center from January 1, 2015 to September 30, 2021. Inclusion criteria were age greater than 18 years and diagnosis of NASH or cryptogenic cirrhosis. Exclusion criteria included non-NASH cirrhosis or PVT secondary to primary coagulopathy. Clinical data was collected including presence of hypertension, hyperlipidemia, Type II diabetes mellitus, obesity and pre-transplant MELD score. Metabolic syndrome was defined using International Diabetes Foundation Criteria. Data was analyzed using SPSS software. The study was approved by the IRB.

Results: Of the 238 patients with NASH cirrhosis, 57 patients had a PVT at time of evaluation for a prevalence of 23.9%. Univariate analysis, demonstrated hyperlipidemia (p = 0.02), obesity (p = 0.02), metabolic syndrome, and beta blocker use to be associated with portal vein thrombosis. On multivariate analysis presence of metabolic syndrome (OR: 2.37, CI: 1.21-4.63, p = 0.011) and beta blocker (OR:2.14, CI: 1.07-4.29, p = 0.031) use were independently associated with portal vein thrombosis. The prevalence of PVT was 34% in metabolic syndrome and 20% in beta blocker users. Metabolic syndrome with concurrent BB use did not seem to confer additional risk of PVT (Table 1). Metabolic syndrome was found in 71.9% of NASH cirrhosis patients with portal vein thromboses. Beta blockers were found in 66.7% of NASH cirrhosis patients with portal vein thromboses.

Discussion: This study demonstrates that presence of metabolic syndrome and use of beta blockers in NASH cirrhosis patients is associated with an increased prevalence of portal vein thrombosis. Increased prevalence of PVT in the metabolic syndrome only group suggests that this might be a greater risk factor than BB use. Further prospective studies are needed to consider the role of treatment and mitigation of metabolic syndrome associated factors and the role of beta blockers in the pathogenesis of portal vein thrombosis in patients with NASH.



Disclosures:


Asahi Hoque, MD, MPH, Cristina Batarseh, MD, Amir A. Qamar, MD. D0497 - Metabolic Syndrome and Beta Blocker Use Is Associated With Portal Vein Thrombosis in NASH Cirrhosis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.